Neptune Richard, Vistamehr Arian
Department of Mechanical Engineering, The University of Texas at Austin, 204 E. Dean Keeton Street, Stop C2200, Austin, TX 78712-1591.
Motion Analysis Center, Brooks Rehabilitation, Jacksonville, FL, USA.
J Biomech Eng. 2018 Dec 5;141(7):0708011-07080110. doi: 10.1115/1.4042170.
Walking can be exceedingly complex to analyze due to highly nonlinear multi-body dynamics, nonlinear relationships between muscle excitations and resulting muscle forces, dynamic coupling that allows muscles to accelerate joints and segments they do not span, and redundant muscle control. Walking requires the successful execution of a number of biomechanical functions such as providing body support, forward propulsion and balance control, with specific muscle groups contributing to their execution. Thus, muscle injury or neurological impairment that affects muscle output can alter the successful execution of these functions and impair walking performance. The loss of balance control in particular can result in falls and subsequent injuries that lead to the loss of mobility and functional independence. Thus, it is important to assess the mechanisms used to control balance in clinical populations using reliable methods with the ultimate goal of improving rehabilitation outcomes. In this review, we highlight common clinical and laboratory-based measures used to assess balance control and their potential limitations, show how these measures have been used to analyze balance in several clinical populations, and consider the translation of specific laboratory-based measures from the research laboratory to the clinic.
由于高度非线性的多体动力学、肌肉兴奋与产生的肌肉力量之间的非线性关系、允许肌肉加速其未跨越的关节和节段的动态耦合以及冗余肌肉控制，步行的分析可能极其复杂。步行需要成功执行多种生物力学功能，例如提供身体支撑、向前推进和平衡控制，特定的肌肉群有助于这些功能的执行。因此，影响肌肉输出的肌肉损伤或神经功能障碍会改变这些功能的成功执行并损害步行表现。尤其是平衡控制的丧失会导致跌倒及随后的损伤，进而导致行动能力和功能独立性的丧失。因此，使用可靠的方法评估临床人群中用于控制平衡的机制非常重要，其最终目标是改善康复效果。在这篇综述中，我们重点介绍了用于评估平衡控制的常见临床和基于实验室的测量方法及其潜在局限性，展示了这些测量方法如何用于分析多个临床人群的平衡，并考虑将特定的基于实验室的测量方法从研究实验室转化到临床应用。
